• 지역사회간호학회지
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• 제33권2호
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• pp.139-152
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• 2022

Purpose: This study aims to describe and understand the meaning and nature of community health practitioners' coping with COVID-19. Methods: In-depth interviews were conducted with 12 community health practitioners from August to October 2021, to describe and understand the nature of their coping with COVID-19. The collected data were examined and described based on Colaizzi's phenomenological method. Results: 16 theme clusters and five categories were derived from the community health practitioners' experience of coping with COVID-19. The categories derived were: a war that began without notice, a variety of correspondence tasks assigned, struggling to fulfill given roles, correspondence tasks becoming more systematic, and a fight that has not yet ended. Conclusion: Community health practitioners handled various response tasks related to COVID-19, and faithfully fulfilled their professional roles while performing the primary task of medical care. Hence, attention is required on issues related to the establishment of the national emergency healthcare system and improvement of professional competence of community health practitioners even after the COVID-19 pandemic is over. Furthermore, it is necessary to make ceaseless efforts to address those issues and, in order to do so, social interest and institutional support are needed.

• 가정∙방문간호학회지
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• 제20권2호
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• pp.124-132
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• 2013

Purpose: The purpose of the present study was to identify correlations between resilience, job stress, and burnout in new nurses. Methods: The participants were recruited from a university hospital. All participants (N=87) were new nurses whose clinical experience was 12 month and less. We gathered data regarding demographics, resilience, job stress, and the incidence of burnout among the nurses using structured questionnaires. We analyzed the data using t-test, one-way ANOVA, Pearson correlation, coefficien and multiple regression analyses. Results: Resilience of the nurses was negatively correlated with job stress (r=-.377, p<.001) and burnout (r=-.568, p<.001), while job stress was positively correlated with burnout (r=.511, p<.001). Resilience and job stress explained 42.5% of the variance in nurses' burnout ($R^2$=.425, F=37.071, p<.001). Conclusion: These results of the present study indicate that the management programs to address job stress and resilience for new nurses should be needed to reduce the burnout among them.

• 한국융합학회논문지
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• 제12권5호
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• pp.373-383
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• 2021

우리 사회는 빠른 속도로 고령화가 진행되고 있다. 이러한 초고령화 사회에서는 의료비 증가도 늘어나고 있으며 이 상황은 사회보장제도의 지속가능성을 저하시키는 국가적인 문제로 인식되고 있다. 이를 해결하기 위해 노인 건강관리를 위한 다양한 서비스가 추진되어왔지만 대부분 취약계층, 만성질환 발병 후 건강관리에 집중해 왔으며 예방차원의 건강관리는 부족하였고 대부분 시범사업으로 그치고 있는 것이 현실이다. 이에 본 논문에서는 국내외 노인대상 건강관리 서비스의 현황을 분석하고 이를 근거로 한계점과 개선점을 분석하여 IoT 기반의 토탈실버케어센터 구축을 제안하였다. IoT 기반의 토탈실버케어센터는 다양한 센서, 의료기기, 스마트밴드 등을 통해 노인들의 건강상태를 편리하게 모니터링 할 수 있으며, 이를 바탕으로 긴급히 방문해야 하는 사용자를 구분하여 간호제공자의 시간절약 및 업무의 효율화를 통해 간호서비스의 질을 향상시킬 수 있다. 또한 사용자의 건강상태 변화가 있는 경우 건강간호 중재를 적시에 제공할 수 있을 뿐만 아니라 실시간 영상시스템을 통해 정신적인 어려움을 극복하는데 도움을 줄 수 있다.

• 한국노년학
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• 제29권2호
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• pp.645-656
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• 2009

본 연구는 의료기관 가정간호사업 현황을 총체적으로 파악하여, 의료기관 가정간호사업 활성화와 노인장기요양보험제도 도입 이후 세 가지 유형의 가정방문 간호사업을 효율적으로 기능역할 정립하는데 필요한 기초자료를 생성하기 위함이다. 건강보험심사평가원의 2006년 의료기관 가정간호 급여청구자료를 2차 분석하고, 전국 75개 의료기관 가정간호사업소의 사업현황을 횡단적 조사 분석하였다. 2006년 전체 의료기관 가정간호 이용자 중 65세 이상 노인은 20,343명(전체 대상자의 64.0%), 급여 청구는 98,822건(전체 청구의 70.1%), 방문은 333,889건(전체 방문의 76.8%)이었다. 이용자의 진단명은 뇌졸중 23.6%, 뇌졸중을 제외한 심장 등 순환기질환이 17.7%로 전체 청구 중 41.3%가 뇌졸중을 비롯한 순환기질환에 의한 것이었다. 다음은 당뇨 등 내분비계질환 10.4%, 신생물 9.7% 순이었다. 2006년 일 년간 노인대상 의료기관 가정간호 총 진료비는 13,247,992,290원(전체의 70.5%), 가정간호비용은 6,544,430,760원(전체의 72.2%)이었다. 2006년 일 년간 의료기관 가정간호 서비스 이용 노인 일인당 평균 총 진료비는 646,262원, 가정간호비용은 319,476원, 총 방문건수는 15.3건이었다. 의료기관 가정간호사업은 보건소 방문보건사업과 중재 종류는 유사하나, 보건소 방문보건사업에서는 수행되지 않는 헤마토크릿(16.8%), 혈색소(15.6%), 적혈구 침강속도(5.6%), 경피적산소분압(0.1%) 등 임상검사와 흡입배농 및 배액(0.7%), 약물저류 관장(0.1%) 및 가스관장(0.01%)등 특수처치가 수행되었다. 건강보험 급여한도 월 8회를 초과하여 전액본인부담금으로 의료기관 가정간호를 이용한 노인은 질환별로 욕창 7.0%, 암 5.4%, 당뇨 2.5%, 고혈압 1.1%, 뇌졸중 0.9%였다. 따라서, 이러한 서비스 차이를 반영하여 세 가지 유형의 가정방문 간호사업간 기능역할을 설정하고, 서비스 이용을 활성화하기 위해서 보험급여를 확대할 필요가 있다.

• 대한간호학회지
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• 제35권7호
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• pp.1229-1237
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• 2005

Purpose: The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals. Method: The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of $71.8\%$. Result: (a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid. penalties ($65.9\%$). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain ($61.5\%$), lower back pain ($54.1\%$), knee pain ($39.4\%$), and gastrointestinal problems ($33.0\%$). Conclusion: These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.

• Nutrition Research and Practice
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• 제15권6호
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• pp.789-797
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• 2021

BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m². Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.

• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.238-247
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• 2023

Objectives: Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers' knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services. Methods: This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants. Results: Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs' side effects; and the quality of health workers and HIV services. Conclusions: There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.

• 대한치과의사협회지
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• 제48권1호
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• pp.6-11
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• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• Journal of Preventive Medicine and Public Health
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• 제57권4호
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• pp.356-369
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• 2024

Objectives: The objective of this study was to explore healthcare providers' experiences in managing the coronavirus disease 2019 (COVID-19) pandemic and its impact on healthcare services. Methods: A qualitative study was conducted with 34 healthcare professionals across 15 districts in Bangladesh. Among the participants, 24 were health managers or administrators stationed at the district or upazila (sub-district) level, and 10 were clinicians providing care to patients with COVID-19. The telephone interviews were conducted in Bangla, audio-recorded, transcribed, and then translated into English. Data were analyzed thematically. Results: Most interviewees identified a range of issues within the health system. These included unpreparedness, challenges in segregating COVID-19 patients, maintaining isolation and home quarantine, a scarcity of intensive care unit beds, and ensuring continuity of service for non-COVID-19 patients. The limited availability of personal protective equipment, a shortage of human resources, and logistical challenges, such as obtaining COVID-19 tests, were frequently cited as barriers to managing the pandemic. Additionally, changes in the behavior of health service seekers, particularly increased aggression, were reported. The primary motivating factor for healthcare providers was the willingness to continue providing health services, rather than financial incentives. Conclusions: The COVID-19 pandemic presented a unique set of challenges for health systems, while also providing valuable lessons in managing a public health crisis. To effectively address future health crises, it is crucial to resolve a myriad of issues within the health system, including the inequitable distribution of human resources and logistical challenges.

• 여성건강간호학회지
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• 제20권1호
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• pp.62-71
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• 2014

Purpose: This study investigated the effects of menopausal adaptation and Sanhujori (Korean traditional postnatal care) on the Health-related quality of life in middle-aged women. Methods: Women aged from 45 to 60 completed questionnaires consisting of SF-36 ver. 2 and menopausal adaptation scale between July to Aug, 2013. Two hundred and eighteen participants' data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression. Results: Physical health ($69.5{\pm}15.1$) was better than mental health ($68.8{\pm}17.1$), and bodily pain and social functioning were the same results as 2009 general U.S. population, with the sub-variables of quality of life being lower. Menopausal adaptation was at moderate level, and correlation of its sub-variables with quality of life were significant: fatigue (r=.60, p<.001), accomplishing feeling (r=.55, p<.001), confidence (r=.54, p<.001), dryness (r=.51, p<.001), flush (r=.38, p<.001), dominance (r=-.36, p<.001), stability (r=.26, p<.001). Fatigue, confidence, stability, period of sanhujori, and dryness revealed as influencing quality of life, while the total variation explained by these components was at 52%. Conclusion: To improve quality of life of middle aged women, health care providers need to provide nursing intervention to relieve fatigue and dryness; and address psychosocial concerns with developing nursing strategies to improve stability and confidence. For post-partum women, enough periods of sanhujori needs to be recommended.